02D2101938 CLIA NUMBER - WISDOM TRADITIONS COUNSELING SERVICES

Laboratory Demographics

  • CLIA Code: 02D2101938
  • Facility Name: WISDOM TRADITIONS COUNSELING SERVICES
  • Facility Address: 401 W INTERNATIONAL AIRPORT ROAD, SUITE 17
    ANCHORAGE, AK
    ZIP 99518
  • Facility Phone: 907 562-4540
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL DEMOLINA
  • NPI Number: 1881879922
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 02D2101938
LAB Type Comp. Outpatient Rehab Facility
Facility Name WISDOM TRADITIONS COUNSELING SERVICES
Street 401 W INTERNATIONAL AIRPORT ROAD, SUITE 17
City ANCHORAGE
State AK
ZIP 99518
Phone 907 562-4540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director MICHAEL DEMOLINA

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This page was last updated on: 9/29/2025